Special Needs Elderly

Question 1

what are 5 reasons for increased tooth retention in the elderly?

Answer 1

• improved awareness of OH, improved access to care, oral health promotion, fluoride toothpastes, fluoride water supplies and mouthwashes.

Question 2

Is periodontal disease part of the ageing process?

Answer 2

NO

not part of the ageing process but as a consequence of disease progression in the susceptible patient over a number of years

Question 3

At what pH does demineralisation occur?

Answer 3

at pH6.5

Question 4

What pathogens are involved in root surface caries (2)

Answer 4

mutans streptococci and LACTOBACILLI.

Question 5

What are non dietary causes of tooth wear?

Answer 5

alcohol abuse, hiatus hernia, duodenal ulceration, certain medications (ex. NSAIDs).

Question 6

What are complications of dry mouth?

Answer 6

• difficult to wear partial dentures, burning mouth, changes in taste, difficult to chew and speak, swallowing, candidal infection.

Question 7

What may the tongue in a patient with dry mouth look like?

Answer 7

glossy, lobulated, fissured.

Question 7

What medications (3) can induce xerostomia?

Answer 7

• antidepressants (amitriptyline).
• antihypertensives (propranolol, nidefipine)
• anxiolytics (benzodiazepines)

Question 7

What drugs can cause dry mouth (7) - classes and examples

Answer 7

beta blockers (propranolol), ACE inhibitors (lisinopril), diuretics (frusemide), calcium channel blockers (nifedipine), hypnotics (diazepam), antidepressants (amitryptiline), anti-parkinson’s (carbidopa).

Question 7

What are the 6 requirements/ steps for a tooth to be under an overdenture?

Answer 7

• 2 roots symmetrically placed.
• at least 50% bone support remaining.
• tooth should be able to be root filled
• tooth restore with amalgam.
• root left 2-3mm above gingival margin to avoid contact with the denture.
• dome shape on the tooth.

ENABLE TRANSITION FOR PATIENT TO A FULL-FULL DENTURE.

Question 7

What drugs can cause gingival overgrowth?

Answer 7

calcium channel blockers, anti-epileptic drugs (ex. phenytoin), cyclosporin.

Question 8

What are the advantages of overdentures?

Answer 8

• help preserve alveolar bone, aid with stability and retention of the denture, increases psychological well-being for the patient.

Question 9

How can retention of overdentures be enhanced?

Answer 9

Using precision attachments yet this is expensive and only used when essential.

Question 10

What is a negative of overdentures?

Answer 10

require high maintenance

Question 11

What are 3 causes of angular cheilitis?

Answer 11

1. fungal infection.
2. staphylococcal infection from the nasal cavity.
3. iron deficiency anemia.

Question 12

What are 5 factors involved in denture stomatitis?

Answer 12

dental plaque, dental trauma, pathogenicity of candida albicans, continuous denture wear, impaired host defence.

Question 13

What are 3 treatments for denture stomatitis?

Answer 13

1. denture hygiene
2. topical antifungals (miconazole, nystatin).
3. new dentures

Question 14

What are 2 topical antifungals used for denture stomatitis?

Answer 14

miconazole, nystatin.

Question 15

What are the high risk sites for oral carcinoma?

Answer 15

lateral border of the tongue, FOM

Question 16

What is the most common type of oral carcinoma?

Answer 16

90% are squamous cell carcinomas